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Liposuction

Also known as lipoplasty and body contouring surgery

Liposuction surgery sculpts your body, eliminating unwanted pockets of exercise and diet-resistant fat from the buttocks, hips, love handles, saddlebags, thighs, calves, ankles, breasts (including male breasts), back, arms and neck. Liposuction is often combined with other procedures to create a desired shape and is one of the safest and most popular cosmetic procedures.

When to Consider Liposuction

If you have localized areas of fat deposits that are disproportionate with the rest of your body.

If you would like more definition or a sleeker contour in certain areas of your body.

If your skin elasticity is good (Liposuction removes fat, but does not tighten skin).

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Considerations

Pros

Uses small incisions, which result in smaller scars than open body contouring procedures.

Can be done under sedation with less risks and shorter operating times than similar open body contouring procedures.

Cons

Results may be affected by weight gain, aging and pregnancy.

Liposuction is not meant to improve the look of cellulite or loose skin.

You may need to lose weight to be a better candidate for liposuction.

These are the top three pros and cons to weigh when considering liposuction. If you want to focus on those specifically unique to you, please consult with your aesthetic plastic surgeon.

Am I a good candidate for liposuction?

For certain individuals, diet and exercise will never get rid of stubborn pockets of fat. The following are some common reasons why you may want to consider liposuction:

You have a minimal amount of excess skin and good skin elasticity. Loss of skin elasticity with age can compromise liposuction results, but if your skin maintains elasticity, age alone is not a contraindication for liposuction surgery.

You have localized deposits of fat in your abdomen, arms, thighs and/or neck, which may be the result of heredity and do not disappear with exercise and diet.

You are physically fit, no more than 20 pounds overweight, and your weight is stable. If you are planning to lose a significant amount of weight or even gain weight (for example, due to pregnancy), this is not the time to undergo liposuction.

Keep in mind that liposuction does not remove cellulite and cannot tighten loose skin. Your surgeon will be able to recommend other procedures to improve those conditions.

If you are in good general health and have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

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The most ideal patient has a steady weight, stubborn fat pockets, but good skin elasticity.

After recovering from surgery, your body contour will appear smoother and slimmer.

About Your Procedure

How is a liposuction procedure performed?

Liposuction removes fat from your body using suction. In this procedure, small, thin, blunt-tipped tubes (cannula) are inserted through small cuts in the skin. Your plastic surgeon moves these tubes under your skin to target fat deposits and then suction them out. There are a variety of techniques that facilitate liposuction:

Tumescent liposuction describes a “wetting solution” with a local anesthetic, such as lidocaine and another medication in IV fluids, which is injected before surgery, causing blood vessels to shrink down or constrict. This allows liposuction to be performed with the patient under local anesthesia, minimizes blood loss and reduces postsurgical pain and bleeding.

Suction-assisted liposuction (SAL), the most traditional form of liposuction, draws fat out with a vacuum.

Power-assisted liposuction (PAL) is traditional SAL with the addition of a tool to increase the motion of the cannula, which speeds up fat removal.

Ultrasound-assisted liposuction (UAL) transmits energy through a special hand piece that helps to loosen and melt fat, enabling a greater volume of fat to be removed. This is best for larger areas, dense fat and male patients.

VASER, a variation of UAL, is an ultrasonic cannula with several grooves that evenly disperse the energy, improving fat disruption and removal.

Laser-assisted liposuction (LAL), such as Smartlipo and Slimlipo, is a relatively new technology. The theory is that the laser will work like ultrasound to disrupt the fat cells and make fat removal more efficient and less traumatic.

SAFELipo is a procedure that has been developed by an Aesthetic Society member that involves a 3-step process of separation, aspiration and fat equalization.

Separation - loosens, emulsifies and separates out the unwanted fat cells without generating heat, so essential blood vessels, skin and other tissues are unharmed

What are my options?

Some are traditional, such as suction-assisted liposuction (SAL), and others are relatively new. It is important to know that while some new technologies can improve your outcome, choosing a procedure based on “what’s new” is never a medically sound decision. Hearing about a brand name procedure such as Smartlipo or CoolLipo on television, through an advertisement or online does not necessarily mean it is the best procedure for you. Your board-certified plastic surgeon will determine what is best for you based on his or her experience, your body type and your cosmetic goals.

What will my liposuction incisions and scars be like?

Because liposuction incisions are small, the scars are also small.

The amount or degree of scarring depends on the surgeon’s technique and your genetic tendencies.

Most liposuction scars fade and are barely perceptible over time. Visible scars are more likely when large liposuction cannulas are used and in patients who have darkly pigmented skin.

There are two types of marks that can remain on the skin after liposuction. One is a true scar and the other is known as dyschromia, which is a dark (hyperpigmented) or light (hypopigmented) spot on the skin.

Generally, the incisions are very small and placed in hidden areas. Sometimes, depending on the area, the incisions cannot be hidden.

Selecting Your Surgeon

Select a surgeon you can trust

It's important to choose your surgeon based on:

Education, training and certification

Experience with liposuction surgery

Your comfort level with him or her

Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your aesthetic procedure. Learn how to select a surgeon.

After finding a board-certified plastic surgeon in your area who is experienced in performing liposuction surgery, you will need to make an office appointment to set up your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.

Your initial consultation appointment

During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for liposuction and clarify what liposuction can do for you. Understanding your goals and medical condition, both alternative and additional treatments may be considered (see related procedures).

During the initial consultation, you can expect your surgeon to:

Ask you to look in a mirror and point out exactly what you would like to see improved.

Take pictures of you, including 3D photos, especially if the areas to be treated are on your rear side (back, buttocks, or other areas). This will help your surgeon understand your expectations and determine if liposuction can achieve them.

Discuss your ideal weight, realistic weight and current weight. He or she may suggest a weight loss program before surgery.

Ask you about your plans regarding future pregnancies.

You should come to the consultation prepared to discuss your complete medical history. This will include information about:

Previous surgeries

Past and present medical conditions, including any history of high blood pressure, thyroid problems or diabetes

Allergies and current medications

Your treatment plan

Based on your goals, physical characteristics and the surgeon’s training and experience, your surgeon will share recommendations and information with you, including:

An approach to your surgery, including the type of procedure of combination of procedures.

The outcomes that you can anticipate.

Your financial investment in the procedure.

Associated risks and complications.

Options for anesthesia and surgery location.

What you need to prepare for your surgery.

What you can expect to experience after surgery.

Share before-and-after photos of cases similar to yours and answer any questions.

Questions to ask your aesthetic plastic surgeon

For a general list of questions to ask your surgeon about his or her background, to find out about plastic surgery safety and to plan your procedure, visit the Planning Toolkit.

We developed these questions to help you:

Make the most informed and intelligent decisions about your procedure.

Confirm that you have the right surgeon for your procedure.

Make your initial consultation as rewarding as possible.

Understand your options, potential outcomes and risks.

It is important for you to take an active role in your surgery, so please use this list of questions as a starting point for your initial consultation:

Am I a good candidate for liposuction?

Are the results I am seeking reasonable and realistic?

Do you have before-and-after photos I can look at for the procedure I am undergoing?

Will my scars be visible? Where will my scars be located?

What kind of anesthesia do you recommend for me?

What will be the costs associated with my surgery?

What will you expect of me to get the best results?

What kind of recovery period can I expect and when can I resume normal activities?

What are the risks and complications associated with my procedure?

How are complications handled?

What are my options if the cosmetic outcome of my surgery does not meet the goals we agreed on?

Preparing For Your Procedure

How do I prepare for a liposuction procedure?

Your surgeon will provide you with preoperative instructions, answer any questions you may have, take a medical detailed medical history and perform a physical exam to determine your fitness for surgery.

Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.

If your surgeon recommends weight benchmarks or lifestyle changes, do your best to achieve them to ensure the best results and minimize the chance of complications.

Liposuction surgery is usually performed on an outpatient basis. If this is the case, be sure to arrange for someone to drive you home after surgery and stay with you at least the first night following surgery. If you are undergoing a large volume of liposuction, you may be asked to stay in the surgical facility overnight.

What can I expect on the day of liposuction surgery?

Your liposuction surgery may be performed in an accredited hospital, free-standing ambulatory facility or office-based surgical suite. Most liposuction procedures take ninety minutes or less to complete but may take longer depending on how much fat is removed and the number of liposuction sites. If multiple sites on both sides of the body are suctioned, the procedure could take over three hours.

You will receive medications to make you as comfortable as possible during the surgical procedure. Frequently, local anesthesia and intravenous sedation are used for patients undergoing liposuction, although general anesthesia is sometimes desirable.

For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

Your plastic surgeon will follow the surgical plan discussed with you before surgery. Once the operation has begun, he or she may decide to combine various techniques or change a technique to ensure the best result. It is important that you feel comfortable and trust your doctor to make these decisions.

After surgery, you will be taken into a recovery area where you will continue to be closely monitored. You will most likely be wearing a compression garment to help “shrink” the skin. Many patients state that the area feels sore, as if they underwent a vigorous workout.

You will probably be permitted to go home after a short observation period unless you and your plastic surgery have made other plans for your immediate postoperative recovery.

Aftercare And Recovery

Your surgeon will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your postsurgical care, including information about:

Immediately after your liposuction surgery
The incisions where the doctor inserted the cannula may be leaky or drain fluids for several days. In some cases, the doctor may insert a drainage tube to drain fluid away from the wound.

You will wear special tight garments to keep your skin compressed. Your doctor will tell you how long to wear these, usually for weeks. Some doctors provide these garments but others will tell you where to purchase them before your surgery.

When the anesthesia wears off, you may have some pain. If the pain is extreme or long-lasting, contact your physician. You will also have some redness and swelling after the surgery. In some cases, the swelling will remain for weeks or even months. Contact your surgeon to find out if your pain, redness and swelling is normal or a sign of a problem.

Recovery time frame after liposuction
It is vitally important that you follow all patient care instructions provided by your surgeon. This will include information about wearing compression garments, taking an antibiotic, if prescribed, and the level of activity that is safe. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

The first two weeks

The first few days after surgery, you should rest quietly. Elevate the affected body part if possible. Remember, you must not take aspirin or certain anti-inflammatory medications. You will most likely wear a postsurgical garment; if it is too tight, notify your surgeon.

The first 48 hours after surgery, you will experience varying degrees of swelling and bruising. The swelling is maximal at 48 hours after surgery and mostly disappears within two to three weeks, but there may be slight residual swelling for up to four months. Bruising is normal and typically disappears within seven to ten days.

Sutures, if placed, are usually removed seven to ten days after liposuction.

Do not smoke after your liposuction surgery to prevent coughing and bleeding. Do not drink alcohol for five days after surgery or while you are taking pain medication.

Avoid straining, bending over and lifting during the early postoperative period. In many cases, you will be able to resume most of your normal activities within ten days or less.

Discomfort after liposuction is generally limited to soreness rather than pain. Pain medications are prescribed to lessen any discomfort during the first few days.

Patients usually return to work within a few days following a liposuction procedure.

Weeks two to six

It is important to ambulate (walk) as soon as possible after liposuction to discourage swelling and prevent blood clots in the legs. However, avoid strenuous exercise for four to six weeks because it can trigger unnecessary fluid retention in the treated areas.

You should wait a minimum of six weeks before exposure to sun and heat, including sunbathing, because of the possibility of swelling.

You will wear a compression garment over the treated areas for four to six weeks to control swelling and promote skin contraction.

Long-term recovery
Since the healing process is gradual, you should expect to wait at least several months to get an accurate picture of the results of your surgery. The small incisions used for access will fade over a number of months, usually becoming barely visible. For six to nine months, you may experience a fluctuating return of ten to 15 percent swelling with exercise or excessive activity. It is important to see your doctor as scheduled. Follow-up visits will continue for several weeks and then after several months at prescribed intervals.

How Long Will My Results Last?

The results of liposuction surgery are technically permanent because fat cells have been removed. However, your body shape and contours might be affected by weight gain, aging, pregnancy, family genes and lifestyle factors.

It is crucial to maintain healthy habits and a stable weight to maintain liposuction results. Following liposuction, if you continue to eat excess calories, fat will no longer be stored in the cells that have been removed, but will be stored in other body areas.

There is no way to predict where your body will store new fat. What's more, your surgeon will not remove all of the fat cells from your target area, so you could still increase the size of remaining fat cells in that area.

The basic message: keep your weight stable for a long lasting result.

Maintain a relationship with your aesthetic plastic surgeon
For safety, as well as the most beautiful and healthy outcome, it’s important to return to your plastic surgeon’s office for follow-up evaluation at prescribed times and whenever you notice any changes in the treated area. Do not hesitate to contact your surgeon when you have any questions or concerns.

Associated Costs

The cost of liposuction varies from doctor to doctor and from one geographic area to another. Because liposuction is elective surgery, insurance does not cover these costs. Many surgeons offer patient financing plans to make the procedure more affordable.

Patient Experiences and Stories

Carol Ann had liposuction on both her abdomen and her thighs. She had a small pocket of fat around her abdomen that would not respond to healthy eating or exercise. She decided to have liposuction on her stomach, as well as her thighs. Carol Ann's plastic surgeon told her the liposuction on her stomach would leave her with a good result because her muscles were very tight.

After deciding to have a tummy tuck, Lynn thought it best to have body contouring done at the same time. She chose this option to both minimize downtime from having two separate procedures, and to ensure that, once her stomach had been improved and was more taught, that her thighs matched. She talked with her doctor about making her look as natural as possible.

Smart Beauty Guide Stories

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